Müller Weiss disease (MWD) is characterized by lateral navicular necrosis which is associated with a varus alignment of the subtalar joint, varying degrees of arthritis of the talonavicular-cuneiform joints and a paradoxical flatfoot deformity in advanced cases. Although arthrodesis of the hindfoot is commonly used, we present the results of a previously unreported method of treatment using a
Treatment of comminuted intraarticular calcaneal fractures remains controversial and challenging. Anatomic reduction with stable fixation has demonstrated better outcomes than nonoperative treatment of displaced intraarticular fractures involving the posterior facet and anterior calcaneocuboid joint (CCJ) articulating surface of the
This study was designed to characterize the recurrence incidence and risk factors of antibiotic-loaded cement spacer (ALCS) for definitive bone defect treatment in limb osteomyelitis. We included adult patients with limb osteomyelitis who received debridement and ALCS insertion into the bone defect as definitive management between 2013 and 2020 in our clinical centre. The follow-up time was at least two years. Data on patients’ demographics, clinical characteristics, and infection recurrence were retrospectively collected and analyzed.Aims
Methods
Surgical treatment of young femoral neck fractures often requires an open approach to achieve an anatomical reduction. The application of a calcar plate has recently been described to aid in femoral neck fracture reduction and to augment fixation. However, application of a plate may potentially compromise the regional vascularity of the femoral head and neck. The purpose of this study was to investigate the effect of calcar femoral neck plating on the vascularity of the femoral head and neck. A Hueter approach and capsulotomy were performed bilaterally in six cadaveric hips. In the experimental group, a one-third tubular plate was secured to the inferomedial femoral neck at 6:00 on the clockface. The contralateral hip served as a control with surgical approach and capsulotomy without fixation. Pre- and post-contrast MRI was then performed to quantify signal intensity in the femoral head and neck. Qualitative assessment of the terminal arterial branches to the femoral head, specifically the inferior retinacular artery (IRA), was also performed.Aims
Methods
Abstract. Objectives. The fidelity of a 3D model created using image segmentation must be precisely quantified and evaluated for the model to be trusted for use in subsequent biomechanical studies such as finite element analysis. The bones within the ankle joint vary significantly in size and shape. The purpose of this study was to test the hypothesis that the accuracy and reliability of a segmented bone geometry is independent of the particular bone being measured. Methods. Computed tomography (CT) scan data (slice thickness 1 mm, pixel size 808±7 µm) from three anonymous patients was used for the development of the ankle geometries (consisting of the tibia, fibula, talus,
Abstract. Objectives. This abstract provides an update on the Open Ankle Models being developed at the University of Bath. The goal of this project is to create three fully open-source finite element (FE) ankle models, including bones, ligaments, and cartilages, appropriate musculoskeletal loading and boundary conditions, and heterogeneous material property distribution for a standardised representation of ankle biomechanics and pre-clinical ankle joint analysis. Methods. A computed tomography (CT) scan data (pixel size of 0.815 mm, and slice thickness of 1 mm) was used to develop the 3D geometry of the bones (tibia, talus,
Objective. The objective of this study was to evaluate the rotation and
translation of each joint in the hindfoot and compare the load response
in healthy feet with that in stage II posterior tibial tendon dysfunction
(PTTD) flatfoot by analysing the reconstructive three-dimensional
(3D) computed tomography (CT) image data during simulated weight-bearing. . Methods. CT scans of 15 healthy feet and 15 feet with stage II PTTD flatfoot
were taken first in a non-weight-bearing condition, followed by
a simulated full-body weight-bearing condition. The images of the
hindfoot bones were reconstructed into 3D models. The ‘twice registration’
method in three planes was used to calculate the position of the
talus relative to the
The aim of this study was to evaluate the relationship between the location of the insertion point of the AT into the posterior aspect of the
Insertional Achilles tendinitis with considerable degeneration that failed non-operative treatment typically requires tendon debridement and reattachment to bone. It is common practice for tendons to be reattached back with anchor sutures, but this poses a challenge to patients who are not able to afford them. Bony anchorage of tendons may be performed by passing sutures through tunnels, but the strength of repair compared to by using anchors is not known. We investigated the load at clinical and catastrophic failure of these two methods of reattachment. Sixteen paired Achilles tendons along with the
Aims. Management of intra-articular calcaneal fractures remains a debated topic in orthopaedics, with operative fixation often held in reserve due to concerns regarding perioperative morbidity and potential complications. The purpose of this study was to identify the characteristics of patients who developed surgical complications to inform the future stratification of patients best suited to operative treatment for intra-articular calcaneal fractures and those in whom surgery was highly likely to produce an equivocal functional outcome with potential post-operative complications. Methods. All patients who underwent open reduction and internal fixation of calcaneal fractures utilizing the Sinus Tarsi approach between March 2014 and July 2018 were identified using theatre records. Patient imaging was used to assess pre- and post-operative fracture geometry with Computed Tomography (CT) used for pre-operative planning. Each patient's clinical presentation was established through retrospective analysis of medical records. Patients provided verbal consent to participation and patient reported outcome measures were recorded using the Maryland Foot Score. Results. Fifty-eight intra-articular calcaneal fractures (fifty-three patients including five bilateral, mean age = 46.91 years) were included. Forty-nine patients were injured as a result of a fall from a height (92.4%). Mean time from presentation to surgery was 3.23 days (range 0–21). Mean Maryland Foot score was found to be 77.6 (+/− 16.22) in forty-five patients. Five patients (9.4%) had wound complications; two superficial (3.7%) and three deep (5.6%). Conclusion. Intra-articular fractures of the
Background. Surgical management of
Background. A calcaneal medial osteotomy (CMO) is a surgical procedure frequently performed to correct a valgus alignment of the hindfoot. However currently little is known on its accurate influence on hindfoot alignment (HA). Aim. To assess the influence of a CMO on HA in both 2D and 3D measurements using weightbearing CT (WBCT). Methods. Twelve patients with a mean age of 49,4 years (range 18–67yrs) were prospectively included. Indications for surgical correction by a CMO with a solitary translation of the
The flat foot is a frequent deformity in children and results in various levels of functional alterations. A diagnosis based on foot morphology is not sufficient to define the therapeutic approach. In fact, the degree of severity of the deformity and the effects of treatments require careful functional assessment. In case of functional flatfoot, subtalar arthroereisis is the surgical treatment of choice. The aim of this study is to evaluate and compare the functional outcomes of two different bioabsorbable implants designed for subtalar arthroereisis in childhood severe flat foot by means of thorough gait analysis. Ten children (11.3 ± 1.6 yrs, 19.7 ± 2.8 BMI) were operated for flat foot correction [1,2] in both feet, one with the calcaneo-stop method, i.e. a screw implanted into the
Purpose. The goal of Total Ankle Arthroplasty (TAA) is to relieve pain and restore healthy function of the intact ankle. Restoring intact ankle kinematics is an important step in restoring normal function to the joint. Previous robotic laxity testing and functional activity simulation showed the intact and implanted motion of the tibia relative to the
Aim. The aim of this work was to evaluate, via foot and ankle TC scans, the outcomes of the use of a bone substitute (CERAMENT|™G) and the growth of native bone in the treatment of osteomyelitis (OM) of the diabetic foot. Method. In nine patients from July 2014 to December 2016 we used a Calcium Sulphate Hemihydrate + Hydroxyapatite + Gentamicin Sulfate (CSH + HA + GS) compound to fill resected bone voids following surgical intervention in OM diabetic foot cases. Of these nine patients, three were female and six were male and their ages were between 49 and 72 years. Four patients had hindfoot involvement and underwent partial calcanectomy. Two patients presented a rocker-bottom Charcot foot pattern III according to Sanders and Frykberg's classification and were treated with esostectomy of the symptomatic bony prominence of the midfoot. One patient presented OM of the 3°, 4° and 5° metatarsal bones. One patient underwent partial resection of the midfoot and hindfoot with arthrodesis stabilised by an internal-external hybrid fixator. One patient with a Charcot foot pattern IV-V underwent partial talectomy and calcanectomy with arthrodesis stabilised by an internal-external hybrid fixator. In all these patients - after removal of the infected bone - we applied 10 to 20 ml CSH + HA + GS filling the residual spaces with the aim of stabilising the remaining bone fragments. The uniqueness of this product is that it induces native bone growth, while the synthetic bone disappears and antibiotic is released into the surrounding tissues. In March 2018, the above nine patients underwent foot and ankle TC scans to evaluate bone growth. Results. The first four patients showed new bone formation in the
Introduction: Preoperative use of tomodensitometry is a common practice when assessing fractures with intraarticular involvement, helping to determine the most appropriate surgical approach according to the lesions observed. To date, during the surgical procedure itself, radiographical or fluoroscopic controls still largely rely on two dimensions X rays. We assessed the possible benefits of intraoperative tridimensional reconstructions using mobile isocentric fluoroscopy (iso-C-3D) after one year of use. Material and Methods: All the procedures where intra-operative tridimensional fluoroscopy was used were assessed prospectively for one year. The type of osteosynthesis as well as specific modalities of installation and therapeutic measures driven from analysis of the images were analyzed. Results: During the first year of use, intraoperative tridimensional reconstruction had been carried out in 48 procedures in 47 patients. The region involved was
Introduction: This study prospectively measured fifty consecutive patients who had the preoperative diagnosis of osteoarthritis undergoing total knee arthroplasty (TKA) to evaluate the change of the bone mineral density (BMD) of the
Aim. Chronic osteomyelitis of the
When total ankle arthroplasty (TAA) is performed, although tibial osteotomy is instructed to be perpendicular to long axis of tibia, there is no established index for the talar bone corrective osteotomy. Then, we have been deciding the correction angle at the plan for adjustment of the loading axis through whole lower extremities. We studied 17 TAA cases with rheumatoid arthritis (RA). X-ray picture of hip to
Purpose: Fractures of the